Personal Statement | For Veterans, By Veterans

Service Information

Tell us about your military service

Full Name *

Service Number / SSN *

Phone Number *

Branch of Service *

Date Entered Service

Date Departed Service

Additional Service Details (Optional)

Other Service Information

Special Assignments

Combat History

Received Hostile Fire Pay Combat Action Ribbon

Describe your condition and its history

What is your medical condition? *

Be specific about the condition you're claiming

Is this secondary to another condition?

Intel: Include specific dates and events when describing when your condition first appeared. This helps establish service connection.

When and how did this condition first appear? *

How has the condition reappeared over time?

How has your condition progressed?

Describe your current symptoms *

How does this condition affect you daily?

Important: Be honest and specific about how your condition limits you. This is crucial for determining your disability rating.

Impact on Daily Activities

Impact on Work

Impact on Social Life

Medical Treatment Received

Other Relevant Information

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